Date of Award

Spring 4-30-2016

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Committee Member

Kirk Hummer, DNP

Second Committee Member

Brian Garrett, CRNA, DNP

Third Committee Member

Nihad Al Assaad, MD


Heart Failure, Quality of Life, Self-Care, Literacy

Subject Categories

Medicine and Health Sciences


Heart Failure (HF) is a leading cause of morbidity and mortality in the United States with over 5.1 million documented cases (Go, et al., 2013). Patients diagnosed with HF are required to learn a multitude of self-care behaviors to prevent exacerbations, worsening symptoms, and progression of their disease. Further investigation of the relationship between low health literacy levels and health related quality of life (HRQoL) in the patient with HF may help to develop a better understanding of the health education needs of this growing population.

An evaluation of the effects of health literacy scores on the measured HRQoL of the heart failure patient was evaluated. The health literacy level was measured utilizing the Rapid Estimation of Adult Literacy in Medicine – Revised (REALM-R). The health related quality of life was measured utilizing the Minnesota Living with Heart Failure questionnaire, (MLwHF).

The results of the study revealed that out of 46 participants, 45.7% were found to be at risk for low health literacy levels. A regression analysis of the MLwHF score and REALM-R revealed no relationship with a p-value of 0.868 and a r-Sq=0.1%. An evaluation of the measured comorbidities revealed a possible negative correlation with quality of life in this small pilot study that may warrant further investigation.

The article concludes with factors to consider when caring for heart failure patients with low health literacy level and the impact on the HRQoL they experience. This information may be applicable to many individuals with low health literacy levels and other disease processes encountered in the health care environment.



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